Kornimate/medical-research-clean huggingface dataset:
effects of substituting sitting with standing and light intensity activity in free-living conditions on glycaemia in overweight and obese south asian adults

Conditions: Cardiovascular Risk Factor; Cardiovascular Diseases; Diabetes; Type 2 Diabetes; Sedentary Behavior; Sedentary Lifestyle

Summary: the purpose of this study is to examine whether substituting sitting with standing and light-intensity activity in free-living conditions can reduce glycaemia in overweight/obese south asian adults.

anthropometric measurement tools including a stadiometer, a measurement tape and digital weighing scale, activity monitor and flash glucose monitor and sensor will be posted to the participants' home or workplace or research team drop all these items to participants' doorstep to allow participants to take their measures including height, weight, and waist circumference. every participant will have to perform a try-out day of the sitless regimen for 24 hours before starting the study and it will be performed after preliminary testing and before the first experimental condition. those participants will be included for this study who will be able to adhere to the protocol based on a review of the activpal activity monitor data that will be worn during the day. additionally, a second attempt will be offered to them to adhere to the protocol if needed. participants will undertake two separate activity regimens in free-living conditions which will be lasting 4-day each condition in a random order: # sit regimen: participants will be instructed to restrict walking and standing to ≤1 h/day each (total ≤2 h/day ) and the remainder of the waking day will be seated apart from visiting the toilet. they will be allowed to perform their daily activities including cooking and other household activities within the 2 h of permitted walking and standing. #sitless regimen: participants will be instructed to substitute a minimum of 5h/day of sitting with ≥2 h of light-intensity physical activity and ≥3 h of standing. participants will be advised to rise from the seated position for 2-5 min every 30 min to engage in standing /light-intensity physical activities to interrupt their sitting. during each activity regimen, participants will be asked to record all of the activities in an activity logbook. in addition, they will be asked to weigh (using kitchen scales) and record food and beverage consumption in a diary for the first four days (days 1-4) and then replicate the dietary intakes and timings exactly for the second four days (days 8-11). they will need to make sure that each meal contains at least 50% carbohydrate. kitchen scales and a food diary will be provided by the research team. throughout the 11 days, participants will be required to avoid alcohol consumption and performing exercise (e.g. brisk walking, sports, going to the gym, cycling, running etc).

Eligibility criteria:
inclusion criteria: * self-identified south asian ethnicity. * self-report sitting at least 7 hours per day. * overweight or obese exclusion criteria: * unable to speak and read english. * not able to performing light-intensity activities. * diagnosed cardiovascular disease or diabetes.
brain mechanisms of human motivation

Conditions: Major Depressive Disorder; Bipolar Disorder

Summary: this study aims to investigate reward learning across the mood disorder spectrum and to investigate the predictive validity of reward learning for subsequent symptom severity.

the study involves five sessions. in the first session, participants will play a computer task. in the second session, participants will go through a clinical interview and will have an eeg recording while playing another computer task. in the third session, participants will undergo an fmri scan while playing another computer task. all tasks assess reward learning. at three and six months after the final session, participants will come back for a follow-up interview session during which a clinician will assess symptom severity. there will be no intervention in this study.

Eligibility criteria:
inclusion criteria: * written informed consent * right-handed * (for mood disorder group only) stable medication over the past 8 weeks or absence of any psychotropic medications for at least 2 weeks (for follow-up analyses testing effects in medication-free patients): * 6 weeks for fluoxetine, * 6 months for neuroleptics, * 2 weeks for benzodiazepines, * 2 weeks for any other antidepressants * 4 weeks for any mood-stabilizers exclusion criteria: * suicidal ideation where outpatient treatment is determined unsafe by the study clinician * pregnant women or women of childbearing potential who 1) have not completed a negative urine pregnancy test prior to the mri scan and/or 2) are seeking to become pregnant or believe that they may be pregnant * serious/unstable medical illness (e.g., cardiovascular, renal, endocrine, neurologic disease) * clinical or laboratory evidence of hypothyroidism * history of seizure disorder, history or current diagnosis of dementia, score \< 26 on the mmse at screening * history or current diagnosis of the following dsm-iv psychiatric illness: organic mental disorder, schizophrenia, schizoaffective disorder, delusional disorder, psychotic disorder nos, patients with mood congruent or mood incongruent psychotic features, anorexia nervosa, obsessive compulsive disorder * lifetime history of stimulant dependence (e.g., cocaine, amphetamines) * current use of methylphenidate (ritalin) and other adhd medications with dopaminergic effects * patients with a lifetime history of electroconvulsive therapy (ect) * failure to meet standard mri safety requirements

Keywords: depression major depressive disorder bipolar disorder mania hypomania eeg mri reward
detailed assessment of augmented renal clearance in a large mixed intensive care unit population

Conditions: Critical Illness; Augmented Renal Clearance

Summary: this multi-center retrospective cohort study presents a detailed assessment of augmented renal clearance (arc) in a mixed population of adult critically ill patients. epidemiology of arc will be studied in detail in a very heterogeneous population. risk factors for arc will be identified and a predictive scoring system for arc ready to use in clinical practice will be constructed and validated. performance of estimators of kidney function will be measured and a cutoff for arc will be determined for the best estimator. finally clinical impact of arc will be explored using vancomycine and aminoglycosides levels as surrogate marker.

augmented renal clearance will be assessed in detail in a very large and heterogeneous adult critically ill population. analysis will be conducted retrospectively on a multi-center database collected by the m@tric research group. m@tric collects data from all intensive care units (surgical, medical, cardiac) in 3 belgian university hospitals (leuven, ghent, antwerp). anonymised admission, demographic, clinical and laboratory data collected from 2013 until the present will be retrieved from the m@tric database. these data will then be coded and analysed in r statistical software. arc will be defined based on a 24h creatinine clearance (crcl24h) \>=130ml/min/1.73m². epidemiology and risk factors for arc will be studied in order to confirm and clarify past studies which have mostly been done in rather small and specific subsets of patients. a predictive algorithm for arc will be trained and subsequently validated for use in clinical practice. moreover this algorithm will be compared to existing scoring systems, which have not yet found their way into clinical practice. this algorithm will provide the ability to anticipate arc on the intensive care unit. also use of formulae estimating renal function will be evaluated in this population. these estimators will be compared to the crcl24h, which is considered the golden standard in clinical practice. a cutoff for the best estimating formula in order to detect arc will be calculated. finally the impact of arc on serum levels of hydrophilic molecules likes vancomycine and aminoglycosides will be studied. as this research follows a retrospective design these levels will be used a surrogate marker for clinical impact. this will potentially point out some opportunities for future research on the clinical impact of arc.

Eligibility criteria:
inclusion criteria: * having at least one 24h creatinine clearance measurement available exclusion criteria: * any form of renal replacement therapy
neurofilament light chain as a potential marker in behcet's disease

Conditions: Behçet

Summary: to determine the role of neurofilament light chain in behçet's disease with or without neurological affection and its relation to neurological manifestation (either peripheral or central ).

behçet disease is a multisystemic autoinflammatory disorder characterized by recurrent oral and genital ulcer, eye affection, thrombosis and many systems can be affected with the most serious being the nervous system affection which is commonly called neuro-behçet's disease (nbd) in ghita et al, the prevalence of behcet disease in egypt was estimated to be 3.6/100,000 with cns affection occurred in about 13.1% of the patients , while in other study performed in egypt the peripheral neuropathy affection reached 53.3% of the patients with insignificant difference between both upper and lower limb but sensory affection was manifested more than motor affection in those patients. neurofilament light chain (nfl) is a neuronal cytoplasmic protein, which was assumed to have a role as a prognostic biomarker in several neuroimmunological and neurodegenerative diseases. it was documented in peripheral nerve affection of patients with diabetes mellitus and guillainbarré syndrome. recently, some studies documented the presence of high level of nfl chain in serum of neurolupus and primary sjogren's diseases , more over in 2022, karaaslan et al. measured nfl in the cerebrospinal fluid (csf) and found it high in neurobehcet patients and assumed that it can predict the prospective cognitive and somatic disability in nbd patients. so, the investigators aim at our study to assess the role of nfl chain in serum of behcet disease in those with and without peripheral and central nervous system affection and its relation to neurological manifestation.

Eligibility criteria:
inclusion criteria: * any adult patient satisfied international study group criteria of behcet's disease exclusion criteria: * patients with definite diagnosis for any other causes affecting central and peripheral nervous system eg.... 1. infection (viral, bacterial, fungal) 2. toxic 3. drug induced 4. other diseases (multiple sclerosis, neuromyelitis optica) 5. trauma 6. other autoimmune diseases 7. diabetic patients 8. purely degenerative diseases 9. tumours
randomized controlled trial of human papillomavirus testing in primary cervical cancer screening

Conditions: Cervical Cancer; Cervical Intraepithelial Neoplasia

Summary: human papillomavirus (hpv)-based cervical screening is known to increase sensitivity for detection of high-grade cervical intraepithelial neoplasia (cin). randomized trials of longitudinal efficacy are required to assess whether these gains represent overdiagnosis or a protective effect. methods: a total of 12527 women, aged 32-38, attending population-based invitational screening in sweden were randomized 1:1 to hpv test and cytology (intervention arm) or cytology only (control arm). hpv-positive women were invited for a second hpv test at least one year later and women with type-specific persistent infections were then invited to colposcopy. a similar number of random double-blinded procedures are performed in the control arm. women are followed with comprehensive registry-based follow-up. primary outcome is the relative rates of cin grade 2 or worse (cin2/cin3+) found in subsequent screening. secondary outcomes are the relative rates of cin2/cin3+ found in the aseline screening and outcomes stratified by grade of cin (cin 2 or cin3+).


Eligibility criteria:
inclusion criteria: * women aged 32-38 years old * attending the swedish population-based organised cervical screening program exclusion criteria: * not providing informed consent

Keywords: screening human papillomavirus
effects of rosiglitazone on bone in postmenopausal diabetic women

Conditions: Type 2 Diabetes Mellitus; Obesity; Menopause

Summary: the purpose of this study is to evaluate the effect of rosiglitazone on bone metabolism and to assess the association between the changes in bone turnover parameters and plasma cytokine levels in postmenopausal diabetic women

fifty-six obese, drug naive patients with type 2 diabetes mellitus were enrolled and completed the study. twenty-six healthy subjects matched for age and body mass index (bmi) served as nondiabetic controls. all subjects were postmenopausal women with last menses at least 2 years. after the baseline measurements, all subjects were instructed to follow a weight-maintaining diet, based on ada recommendations, and were also encouraged to walk or to jog at least 30 min daily. subsequently, 28 of the diabetic subjects were randomly assigned to receive rosiglitazone (4 mg/day). twenty-eight of diabetic subjects were on diet alone. the randomization procedure was based on a random sequence. all subjects had a complete clinical examination, anthropometric measurements, and laboratory tests at baseline and at the end of the 12th week of the study. laboratory investigations included assessment of: (i) glycemic control (hba1c, fasting plasma glucose and insulin levels, and homeostasis model assessment (homa) index (22); (ii) serum bsalp and active human osteocalcin concentration (ocl) as markers of bone formation; (iii) urine deoxypyridinoline (dpd) as marker of bone resorption. other non-specific bone markers including serum total alp activity, urinary calcium (ca) and phosphate (po4) concentrations were also measured. urine concentrations of dpd (nmol/l), ca and po4 (both in mmol/l) were corrected for their respective urine creatinine (cr) concentrations in mmol/l (urine dpd/cr, urine ca/cr and urine po4/cr respectively). in addition, fasting blood samples were analyzed for plasma cytokine levels including il-1β, il-6 and tnf-α, and for haptoglobin levels.

Eligibility criteria:
inclusion criteria: * newly diagnosed type 2 diabetes mellitus * postmenopausal period exclusion criteria: * recent fracture or osteoporosis * drugs that may affect calcium or bone metabolism or drugs known to interfere with cytokine release * thyroid, parathyroid, pituitary, nutritional, inflammatory, hepatic, renal, or neoplastic disorders * severe cardiovascular disease
optimized coronary interventions explain the best clinical outcomes

Conditions: Coronary Artery Disease

Summary: hypothesis: the clinical outcome of patients with indication of pci and coronary stent implantation that are at high risk of events can be improved with a widespread use of intra-coronary tools that allow a pci optimization (i.e. functional assessment by pressure guidewire and intra-coronary imaging techniques). objective: to evaluate whether the use of pressure guidewire and intra-coronary imaging techniques (mainly optimal coherence tomography) in patients at high risk of events undergoing coronary angiography for myocardial revascularization is associated with an improved clinical outcome in comparison with patient with angiographic alone guided cobalt-chromium everolimus-eluting coronary stenting. methods: prospective observational multicentric international study with a follow-up of 12 months, including 1.000 patients in 40 sites located in 3 european countries (spain, france, and portugal). the control group will be comprised by a similar number of matched patients included in the "extended-risk" cohort of the xience v usa study. pci will be performed following local standard protocols and accordingly to the physician criteria. the use of pressure guidewire will be recommended according to the current guidelines, in patients with angiographically intermediate lesions and in those with multivessel disease. the use of oct will be strongly recommended, as patients included will be considered to be at high risk of events, accordingly to the current recommendations. the primary endpoint will be target lesion failure (tlf) at 1 year.


Eligibility criteria:
inclusion criteria: * at least one of the following high-risk characteristics: lesion length \> 28 mm; reference vessel diameter \ 4.25 mm; chronic total occlusion; bifurcation with side branch ≥ 2 mm; ostial lesion; left main; in-stent restenosis; more than 2 lesions stented in the save vessel; more than 2 vessels treated; acute myocardial infarction; renal insufficiency; ejection fraction \< 30%; or staged procedure. there will be no protocol exclusions on the basis of clinical features or angiographic criteria. the indication of using ccees will be determined by the implanting physician. * informed consent signed exclusion criteria: * patients whose survival is expected to be lower than 1 year at hospital discharge. * patients not willing to participate * patient not simultaneously participating in any interventional study
effectiveness of the health care ceo app for t1d

Conditions: Type 1 Diabetes Mellitus

Summary: the present study aims to evaluate the intervention effectiveness of the healthcare chief executive officer mobile application(healthcare ceo app) in patients with type 1 diabetes transitioning from adolescence to early adulthood.

aim:the present study aims to evaluate the intervention effectiveness of the healthcare chief executive officer mobile application in patients with type 1 diabetes transitioning from adolescence to early adulthood. design: a 9-month two-arm, parallel-group, single-blind, randomized controlled trial methods: ninety-six type-1 diabetes patients, aged 16-25 years, are expected to participate in this study. participants will be randomly assigned to the experimental or control group by central randomization. the healthcare chief executive officer app, which consists of the following functions: data recording, knowledge, communication skills, food swap guide, exercise recommendations, chatroom, reminders, and sos, will be used as the intervention measure. we will compare the differences in disease control outcomes, confidence in self-management, self-care behaviors, emotional distress, quality of life, and specific diabetes-related knowledge between the two groups before intervention and at 3, 6, and, 9 months post-intervention. the differences within the experimental group pre- and post- intervention will also be analyzed. this study design was approved by the ethics committee of the researcher's affiliation in march 2021.

Eligibility criteria:
inclusion criteria: * a confirmed diagnosis of t1d by an endocrinologist before the age of 16 and a disease duration of \>6months * patients aged 16-25 years * mean hba1c level ≥7.5% one year before inclusion * ability to communicate in chinese or mandarin * patients who own smartphones with internet access * patients who agreed to voice recording during a session explaining the treatment process * patients who signed the informed consent form prior to participation; for minors, a legal representative must provide consent and sign the informed consent form. exclusion criteria: ･ t1d patients with other concomitant metabolic diseases, chromosomal aberrations, major illnesses, and cognitive impairment will be excluded from this study.

Keywords: type 1 diabetes transition mobile health treatment fidelity
postoperative oral methadone after major spine surgery; safety, feasibility and efficacy in prevention of progression to chronic opioid usage at 3 months

Conditions: Spine Surgery

Summary: the purpose of this study is to evaluate the feasibility and safety of a clinical protocol based on the administration of intraoperative intravenous methadone followed by a short regimen of oral/iv (if the patient is not able to take oral) methadone following spine surgery and to evaluate if methadone decreases persistent opioid usage at 3 months in comparison to placebo.


Eligibility criteria:
inclusion criteria: * adults undergoing multilevel complex lumbar and/or thoracic spine fusion surgery, including revision surgeries exclusion criteria: * bmi greater than 40

Keywords: opioids
a prospective cohort study of exercise rehabilitation in the treatment of parkinson's disease

Conditions: Parkinson Disease

Summary: the investigators proposed to conduct a cohort study to observe whether tai chi intervention could delay the disease progression of parkinson's disease (pd). pd patients were enrolled into 5 tai chi classes which began at different timepoints from jan. 2016 to jan. 2019. each participant was assessed before participants joined the tai chi class. after the recruitment, participants accepted continuous tai chi training in the classes till the last follow-up. the investigators performed three times of follow-up in nov. - dec. 2019, oct. - nov. 2020 and jun. - july 2021. using propensity score matching, the investigators matched pd patients who did not receive tai chi training as control group in gender, disease duration, age, and hoehn - yahr staging. the aim is to observe the effect of tai chi on delaying the disease progression of pd.


Eligibility criteria:
inclusion criteria: 1. clinical diagnosis of parkinson's disease according to 2015 mds diagnostic criteria and united kingdom brain bank diagnostic criteria in 1992; 2. hoehn - yahr staging: 1 - 2.5; 3. the medication was stable at least 3 months before recruiting and not changed during follow-up unless increasing antiparkinsonian drugs or the need of deep brain stimulation (dbs) is required according to the disease severity; exclusion criteria: 1. secondary causes, such as inflammatory, drug-induced, vascular and toxin-induced parkinsonism. 2. parkinsonism with other neurodegenerative diseases, such as progressive supranuclear palsy, multiple system atrophy, cortical basal ganglia degeneration, wilson's disease. 3. other neurological diseases, such as stroke. 4. patients who were receiving any other clinical trials or regular exercise protocols. 5. patients who had fall incidents in the 6 months before recruiting due to safety considerations. 6. patients whose mini-mental state examination (mmse) scores were less than 24. 7. patients who had medical history that did not fit to exercise, such as orthopedics diseases or cardiopulmonary dysfunction. 8. patients who received education less than 6 years. 9. patients who could not walk and live independently. 10. patients who received brain surgery (e.g. deep brain stimulation); 11. patients whose exercise length longer than 50 minutes per week.
recombinant human relaxin for the treatment of decompensated chf

Conditions: Congestive Heart Failure (CHF)

Summary: two doses of relaxin will be compared to placebo for the treatment of patients with decompensated chf

pilot clinical data suggest that recombinant human relaxin may be effective in treating patients with decompensated chf. this study will randomize patients in blinded manner to one of two doses of intravenous relaxin or placebo. serial evaluations will include cardiac and renal function, as well as safety and tolerability.

Eligibility criteria:
inclusion criteria: * hospitalization * decompensated chronic chf (nyha class iii-iv) * lvef \< 35% * pcwp \> 22 mmhg * ci \< 2.3 l/min/m2 exclusion criteria: * acute chf * acute coronary syndrome * hypotension or shock * recent stroke * allergy or sensitivity to test agents * significant confounding conditions or medications

Keywords: congestive heart failure relaxin hemodynamics renal function